Trump could get a big win-win on healthcare by proposing a single-payer system using the VA system as a model. It works (be patient, read article below) and could be scaled to the entire USA. Two beneficial effects:
1) eliminates unnecessary middlemen, the private insurance companies, saving beaucoup dollars [we all love our insurance companies, don't we?]
2) solves the biggest problem the VA system currently has, namely, determining who has VA coverage.
1) eliminates unnecessary middlemen, the private insurance
companies, saving beaucoup dollars [we all love our
insurance companies, don't we?]
The problem with single player is exactly that it would put the government in the same position as insurers. It'll give people even more reason to resent government.
The fact that people still believe that both the VA and the USPS are prime examples of government gone _wrong_ should tell you everything about how well a national single-payer system would work out. Even if it was a success by the numbers, it would never be a political success. The political costs would be tremendous and perpetual.
Look at Social Security. Most conservative voters think it's a broken system, even though by the numbers it's one of the most successful and well-run programs anywhere in the world, public or private.
The baby boomer gap is easily fixed by adjusting the age of retirement, which was precisely how the system was designed to operate from the very beginning. But in the present political climate politicians 1) avoid proper maintenance while 2) simultaneously blaming "government" for the prospective short fall purely of their own creation.
The only politically viable single-payer system would be state based. There's no European Union-wide single-payer system, either.
Funding it, though, raises all sorts of problems. It's difficult for states to fund such a system independently because the Federal government soaks up so many tax dollars to spend on the military and pre-existing health programs. It's extremely difficult as a political matter to both devolve powers _and_ the requisite tax dollars back to the states. At the same time, improving the function and efficiency of federal programs is difficult given a ruling party which actively tries to sabotage those programs, even though they're politically _unable_ even among themselves to make the hard decisions that make the alternative--devolution--feasible.
I don't understand why people bring up the VA as a system to be emulated. My father worked for the VA for thirty years and was basically persecuted for being a whistleblower, denied promotion 'for lack of leadership' (despite the fact that as a captain in the navy he implemented the navy's first fleetwide all-digital database inventory system). Meanwhile abuse and malfeasance are systemic because employees have an attitude of entitlement about their jobs. All of those accusations leveled at Uber in the past week - are basically echoes of things that I have heard about the VA (especially the "slanty-eyed-joe" one, since my dad was asian-american, and he heard similar slurs even in hawaii where the majority of the population is asian.
You don't want to be treated under a system like the VA. It is not a model.
> Trump could get a big win-win on healthcare by supporting a single-payer system.
Sure, I'd like to see that plan regardless of who proposed it, but aside from speculation about Trump's own actual preferences and goals (which obviously play a role in what he would support), I'm not sure embracing the epitome of what Republicans have attacked as socialism would do anything but lose him support (and not just on this issue) within his own party, without buying him any support (except maybe on that one issue) from the opposing party.
It would probably be a good way to Republicans in Congress on board with investigating the Russia issue, with an eye toward President Pence.
A "big win-win" for who though? Health care insurance companies are probably among the biggest beneficiaries of the current system and contribute large sums to both parties to ensure it's continued existence.
If Trump did this he'd be doing exactly what Paul Ryan and other Republican Trump allies have been promising not to do, so while it would be nice to imagine Trump is an actual populist who might take some cues from former aggressive populists, it's quite unlikely that we'll see him do that.
> Trump could get a big win-win on healthcare by proposing a single-payer system
hmm, but wha-
> Furthermore, he could bring in Bernie Sanders to implement it
uh... yeah, the Republicans aren't going to go for that. The President doesn't get to adopt the role of dictator for four years (as much as many would wish they do), and there is zero chance Republicans would go for this.
Right now many Republicans are tolerating Trump's antics because they see him as a means to implement the legislation they've wanted for the last eight years. If that turns out to not be true they'll kick him to the curb.
I remember the complaints that he wasn't proposing something specific before the election. So actually I don't think most people are aware that it is complicated. Otherwise they wouldn't have expected a simple solution.
> Because of the intricate procedures that govern budget legislation and the inherent complexity of health care, Republicans appear unlikely to undo the health law as quickly as they had hoped. Mr. Trump said Congress must tackle the Affordable Care Act before it can overhaul the tax code, also a high priority for Republicans. And those delays could slow work on other priorities like a trillion-dollar infrastructure push.
It's like he left them a 6th grade level puzzle, knowing the bucket of 3rd grade idiots won't be able to solve it, and hopefully they'll be stuck banging it against their heads until they get voted out of office..
[+] [-] giardini|9 years ago|reply
1) eliminates unnecessary middlemen, the private insurance companies, saving beaucoup dollars [we all love our insurance companies, don't we?]
2) solves the biggest problem the VA system currently has, namely, determining who has VA coverage.
"The VA: Another reason for single payer":
http://www.pnhp.org/the-va-another-reason-for-single-payer
Furthermore, he could bring in Bernie Sanders to implement it (second article below) since Sanders is fully up-to-speed on this topic.
"VA: Do we awfulize, or do we fix it? Chairman Sanders Lays Out Legislative Action Plan for Veterans":
http://www.pnhp.org/news/2014/june/va-do-we-awfulize-or-do-w...
[+] [-] wahern|9 years ago|reply
The fact that people still believe that both the VA and the USPS are prime examples of government gone _wrong_ should tell you everything about how well a national single-payer system would work out. Even if it was a success by the numbers, it would never be a political success. The political costs would be tremendous and perpetual.
Look at Social Security. Most conservative voters think it's a broken system, even though by the numbers it's one of the most successful and well-run programs anywhere in the world, public or private.
The baby boomer gap is easily fixed by adjusting the age of retirement, which was precisely how the system was designed to operate from the very beginning. But in the present political climate politicians 1) avoid proper maintenance while 2) simultaneously blaming "government" for the prospective short fall purely of their own creation.
The only politically viable single-payer system would be state based. There's no European Union-wide single-payer system, either.
Funding it, though, raises all sorts of problems. It's difficult for states to fund such a system independently because the Federal government soaks up so many tax dollars to spend on the military and pre-existing health programs. It's extremely difficult as a political matter to both devolve powers _and_ the requisite tax dollars back to the states. At the same time, improving the function and efficiency of federal programs is difficult given a ruling party which actively tries to sabotage those programs, even though they're politically _unable_ even among themselves to make the hard decisions that make the alternative--devolution--feasible.
[+] [-] dnautics|9 years ago|reply
You don't want to be treated under a system like the VA. It is not a model.
[+] [-] dragonwriter|9 years ago|reply
Sure, I'd like to see that plan regardless of who proposed it, but aside from speculation about Trump's own actual preferences and goals (which obviously play a role in what he would support), I'm not sure embracing the epitome of what Republicans have attacked as socialism would do anything but lose him support (and not just on this issue) within his own party, without buying him any support (except maybe on that one issue) from the opposing party.
It would probably be a good way to Republicans in Congress on board with investigating the Russia issue, with an eye toward President Pence.
[+] [-] chadgeidel|9 years ago|reply
[+] [-] KirinDave|9 years ago|reply
[+] [-] untog|9 years ago|reply
hmm, but wha-
> Furthermore, he could bring in Bernie Sanders to implement it
uh... yeah, the Republicans aren't going to go for that. The President doesn't get to adopt the role of dictator for four years (as much as many would wish they do), and there is zero chance Republicans would go for this.
Right now many Republicans are tolerating Trump's antics because they see him as a means to implement the legislation they've wanted for the last eight years. If that turns out to not be true they'll kick him to the curb.
[+] [-] KirinDave|9 years ago|reply
It's just such a strange thing to say.
[+] [-] untog|9 years ago|reply
a) don't have to worry about costs
b) have someone arrange it for them
Primarily it shows that for all the bluster about Trump standing up for the "common man", he has absolutely no idea how the common man lives.
[+] [-] facepalm|9 years ago|reply
[+] [-] refurb|9 years ago|reply
It's worse than even that.
[+] [-] sabertoothed|9 years ago|reply
We all knew it was complex. He said it wasn't. But had no clue.
[+] [-] snowwolf|9 years ago|reply
[+] [-] unknown|9 years ago|reply
[deleted]
[+] [-] british_india|9 years ago|reply
[+] [-] mkaziz|9 years ago|reply
[+] [-] netsharc|9 years ago|reply
It's like he left them a 6th grade level puzzle, knowing the bucket of 3rd grade idiots won't be able to solve it, and hopefully they'll be stuck banging it against their heads until they get voted out of office..